PURPOSE This study aimed to evaluate patellar tendon loading profiles (loading index, based on loading peak, loading impulse, and loading rate) of rehabilitation exercises to develop clinical guidelines to incrementally increase the rate and magnitude of patellar tendon loading during rehabilitation. METHODS Twenty healthy adults (10 females/10 males, 25.9 ± 5.7 yr) performed 35 rehabilitation exercises, including different variations of squats, lunge, jumps, hops, landings, running, and sports specific tasks. Kinematic and kinetic data were collected, and a patellar tendon loading index was determined for each exercise using a weighted sum of loading peak, loading rate, and cumulative loading impulse. Then the exercises were ranked, according to the loading index, into tier 1 (loading index ≤0.33), tier 2 (0.33 < loading index <0.66), and tier 3 (loading index ≥0.66). RESULTS The single-leg decline squat showed the highest loading index (0.747). Other tier 3 exercises included single-leg forward hop (0.666), single-leg countermovement jump (0.711), and running cut (0.725). The Spanish squat was categorized as a tier 2 exercise (0.563), as was running (0.612), double-leg countermovement jump (0.610), single-leg drop vertical jump (0.599), single-leg full squat (0.580), double-leg drop vertical jump (0.563), lunge (0.471), double-leg full squat (0.428), single-leg 60° squat (0.411), and Bulgarian squat (0.406). Tier 1 exercises included 20 cm step up (0.187), 20 cm step down (0.288), 30 cm step up (0.321), and double-leg 60° squat (0.224). CONCLUSIONS Three patellar tendon loading tiers were established based on a combination of loading peak, loading impulse, and loading rate. Clinicians may use these loading tiers as a guide to progressively increase patellar tendon loading during the rehabilitation of patients with patellar tendon disorders and after anterior cruciate ligament reconstruction using the bone-patellar tendon-bone graft.

中文翻译：

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康复训练期间的髌腱负荷进展：对治疗髌腱损伤的影响。


目的本研究旨在评估康复练习的髌腱负荷曲线（负荷指数，基于负荷峰值、负荷脉冲和负荷率），以制定临床指南，以逐步增加康复期间髌腱负荷的速率和幅度。方法 20 名健康成年人（10 名女性/10 名男性，25.9 ± 5.7 岁）进行了 35 项康复练习，包括不同形式的深蹲、弓步、跳跃、单脚跳、落地、跑步和运动特定任务。收集运动学和动力学数据，并使用负荷峰值、负荷率和累积负荷脉冲的加权和确定每次练习的髌腱负荷指数。然后根据负荷指数将练习分为1级（负荷指数≤0.33）、2级（0.33<负荷指数<0.66）、3级（负荷指数≥0.66）。结果单腿下蹲深蹲显示出最高的负荷指数（0.747）。其他第 3 级练习包括单腿向前跳跃（0.666）、单腿反向跳跃（0.711）和跑切（0.725）。西班牙深蹲被归类为二级运动（0.563），跑步（0.612）、双腿反向跳（0.610）、单腿垂直跳（0.599）、单腿全蹲（0.580）、双人-腿下落垂直跳（0.563）、弓步（0.471）、双腿全蹲（0.428）、单腿60°深蹲（0.411）和保加利亚深蹲（0.406）。第 1 级练习包括 20 厘米上台阶（0.187）、20 厘米下台阶（0.288）、30 厘米上台阶（0.321）和双腿 60° 深蹲（0.224）。结论 根据负荷峰值、负荷脉冲和负荷率的组合建立了三个髌腱负荷等级。 临床医生可以使用这些负荷等级作为指导，在髌腱疾病患者康复期间以及使用骨-髌腱-骨移植物重建前交叉韧带后逐渐增加髌腱负荷。